scholarly journals Chronic cerebrovascular diseases: use of vinpocetine in neurological practice (Round Table proceedings)

2018 ◽  
Vol 10 (4) ◽  
pp. 139-145 ◽  
Author(s):  
V. A. Parfenov ◽  
S. A. Zhivolupov ◽  
V. V. Zakharov ◽  
L. A. Belova ◽  
O. V. Lagoda ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Neurological Diseases ◽  
Round Table ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Chronic Cerebral Ischemia ◽  
Dyscirculatory Encephalopathy ◽  
Clinical Presentations

The paper presents the proceedings of the Round Table with the participation of leading neurologists, which is devoted to chronic cerebrovascular diseases. It is noted that chronic cerebral ischemia (CCI), or dyscirculatory encephalopathy (DEP), is one of the most common neurological diagnoses in our country. The pathogenesis, clinical presentations, diagnosis and treatment of CCI (DEP) and its matching with vascular cognitive impairment (CI), which is regarded in foreign literature as the main manifestation of chronic cerebrovascular disease (CVD) were considered. The authors analyze clinical trials evaluating the efficacy of vinpocetine (Cavinton) in chronic CVD, dizziness, CI, as well as the use of new vinpocetine formulations, such as Cavinton Comforte, in various neurological diseases, dysphagia in particular, in poststroke patients.

scholarly journals Vascular cognitive impairment and chronic cerebral ischemia (dyscirculatory encephalopathy)

2019 ◽  
Vol 11 (3S) ◽  
pp. 61-67 ◽  
Author(s):  
V. A. Parfenov
Keyword(s):  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Emotional Disorders ◽  
Blood Lipid ◽  
Vascular Cognitive Impairment ◽  
Considerable Proportion ◽  
Secondary Headache ◽  
Chronic Cerebral Ischemia ◽  
Dyscirculatory Encephalopathy ◽  
Blood Clots

The paper reviews the literature on vascular cognitive impairment (VCI), the diagnosis widely used in foreign neurological practice, as well as chronic cerebral ischemia (CCI) and dyscirculatory encephalopathy (DEP), the common diagnoses in Russian neurological practice. According to the etiology, risk factors, and manifestations, Stages I and II DEP largely corresponds to moderate VCI; Stage III DEP does to severe VCI. The results of the author’s studies show that a considerable proportion of patients followed up with a diagnosis of CCI, DEP, have no signs of chronic cerebrovascular disease (CVD), but suffer from primary or secondary headache, vertigo of various origins, emotional disorders, and other diseases. The diagnosis of CCI, DEP should be based on the presence of CCI, the reliable neuroimaging signs of chronic CVD, and the ruling out of other diseases. When treating and preventing VCI, CCI, and DEP, a premium is placed upon both non-drug (regular physical activity, smoking cessation, rational nutrition) and drug therapy aimed at normalizing blood pressure and blood lipid spectrum, preventing blood clots, and improving cognitive functions.

scholarly journals Longitudinal tracing of neurochemical metabolic disorders in working memory neural circuit and optogenetics modulation in rats with vascular cognitive impairment

2020 ◽  
Author(s):  
Huawei Lin ◽  
Tingting Jin ◽  
Lewen Chen ◽  
Yaling Dai ◽  
Weiwei Jia ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Gray Matter ◽  
Metabolic Disorders ◽  
Neural Circuit ◽  
Vascular Cognitive Impairment ◽  
Chronic Cerebral Ischemia ◽  
Mediodorsal Thalamus ◽  
Ischemia Time

Abstract Objective: Chronic cerebral ischemia leads to vascular cognitive impairment (VCI) that exacerbates along with ischemia time and eventually develops into dementia. Recent advances in molecular neuroimaging contribute to understand its pathological characteristics. We previously traced the anisotropic diffusion of water molecules suggests that chronic cerebral ischemia leads to irreversible progressive damage to white matter integrity. However, the abnormalities of gray matter activity following chronic cerebral ischemia remains not entirely understood.Methods: In this study, in vivo hydrogen proton magnetic resonance spectroscopy (1H-MRS) was applied to longitudinally track the neurochemical metabolic disorder of gray matter associated with working memory, and optogenetics modulation of neurochemical metabolism was performed for targeted treatment of VCI. Results: The results showed that the concentration of N-acetylaspartate (NAA) in the right hippocampus, left hippocampus, right medial prefrontal cortex (mPFC) and mediodorsal thalamus was decreased as early as 7 days after chronic cerebral ischemia, subsequently gamma-aminobutyric acid (GABA) declined whereas myo-inositol (mI) and glutamate (Glu) increased at 14 days, as well as choline (Cho) lost at 28 days, concurrently the change of Glu and GABA in the mPFC and hippocampus was ischemia time-dependent manner within 1 month. Behaviorally, working memory and object recognition memory were impaired at 14 days, 28 days that significantly correlated with neurochemical metabolic disorders. Interestingly, using optogenetics modulation of PV neurons in the mPFC, the metabolic abnormalities of NAA and GABA in working memory neural circuit could be repaired after chronic cerebral ischemia, together with behavior improvements. Conclusions: These findings suggested that as early as 1~4 weeks after chronic cerebral ischemia, the metabolism of NAA, Glu, mI and Cho was synchronously impaired in neural circuit of hippocampus-mediodorsal thalamus-mPFC, and the loss of GABA delayed in the hippocampus, and optogenetics modulation of parvalbumin (PV) neurons in the mPFC can improve the neurochemical metabolism of working memory neural circuit and enhance working memory.

Potential Protective Effect of Dl-3-n-Butylphthalide on Chronic Cerebral Ischemia Brain Injury

2021 ◽  
Vol 21 ◽  
Author(s):  
Fangfang Zhao ◽  
Yumin Luo
Keyword(s):  
Oxidative Stress ◽  
Cerebral Ischemia ◽  
Brain Dysfunction ◽  
Cerebrovascular Diseases ◽  
Pathophysiological Mechanism ◽  
Chronic Cerebral Ischemia ◽  
Celery Seed ◽  
Prevention And Treatment ◽  
Ischemic Cerebrovascular Diseases ◽  
The Common

: Chronic cerebral ischemia is one of the common ischemic cerebrovascular diseases. Chronic cerebral ischemia can lead to brain dysfunction, and its pathophysiological mechanism involves inflammation, blood-brain barrier destruction, oxidative stress, and other factors. Due to it being difficult to detect, it is easily overlooked, and it is often only observed following onset of cognitive dysfunction. At present, there are few drugs for this treatment. DL-3-N-BUTYLPHTHALIDE (NBP), a compound extracted from celery seed, may play an important role in protecting against brain damage caused by chronic cerebral ischemia. Therefore, we pay more attention to the prevention and treatment of NBP on chronic cerebral ischemia.

scholarly journals Cognitive impairment, dizziness, and unsteadiness in hypertensive patients

2020 ◽  
Vol 12 (5) ◽  
pp. 92-97
Author(s):  
L. M. Antonenko ◽  
N. V. Vakhnina ◽  
D. O. Gromova
Keyword(s):  
Cognitive Impairment ◽  
Cerebrovascular Disease ◽  
Brain Damage ◽  
Early Stage ◽  
Clinical Manifestations ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Treatment And Prevention ◽  
Cerebral Microangiopathy ◽  
Selection Of

Hypertension is a widespread disease related to modifiable vascular risk factors for stroke and chronic cerebrovascular diseases. The pathogenetic basis of brain damage in hypertension is cerebral microangiopathy that leads to vascular cognitive impairment (CI), instability, and falls. Microcirculatory changes in the presence of hypertension at the initial stages of cerebrovascular disease occur without visible clinical manifestations of brain damage. Pathogenetically justified treatment used at an early stage of the disease makes it possible to achieve good results in the prevention of vascular brain damage. An important aspect of selecting effective therapy is the competent diagnosis of the causes of dizziness and instability, which can be caused not only by brain damage, but also by peripheral vestibular system diseases. Early diagnosis of vascular CI, selection of adequate therapy, and prevention of their further progression are of great importance. The studies performed have shown the high efficacy of vinpocetine (Cavinton®) that has a multifactorial mechanism of action in the treatment and prevention of CI, dizziness, and instability caused by cerebrovascular disease.

scholarly journals The etiology, manifestations, and therapy of chronic cerebrovascular diseases

2020 ◽  
Vol 12 (5) ◽  
pp. 84-91
Author(s):  
A. G. Gogoleva ◽  
V. V. Zakharov
Keyword(s):  
Cognitive Impairment ◽  
Pathological Condition ◽  
Clinical Manifestations ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
International Standards ◽  
Amyloid Angiopathy ◽  
Neuroradiological Diagnosis ◽  
Genetically Determined

The paper presents the current etiopathogenetic classification of chronic cerebrovascular diseases (CVD) and discusses the role of hypertension, cerebral amyloid angiopathy, and genetically determined syndromes in the development of this pathological condition. It gives recommendations for the neuroradiological diagnosis of chronic CVD in accordance with the international standards. The paper discusses the clinical manifestations of chronic CVD, primarily vascular cognitive impairment. It discusses international guidelines for the examination and treatment of patients with chronic CVD, as well as the rules for stroke prevention in this patient cohort. The possibilities of pathogenetically based therapy in decreasing the severity of vascular cognitive impairment in the presence of chronic CVD are also highlighted.

scholarly journals Biomarkers of vascular cognitive impairment

2021 ◽  
Vol 20 (3) ◽  
pp. 2677
Author(s):  
O. V. Zimnitskaya ◽  
E. Yu. Mozheyko ◽  
M. M. Petrova
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Differential Diagnosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Web Of Science ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Adequate Treatment ◽  
Genetic Biomarkers

There is currently no approved list of vascular cognitive impairment biomarkers. The main problem for the practitioner in identifying cognitive impairment in patients is the differential diagnosis of Alzheimer's disease, vascular cognitive impairment, and other diseases, which are much less common. Vascular cognitive impairment includes post-stroke dementia, cognitive dysfunction in cardio-and cerebrovascular diseases. Without etiology identification, it is impossible to prescribe adequate treatment. Another challenge is identifying cognitive impairment before dementia develops. This literature review is devoted to the search and critical analysis of candidates for biomarkers of vascular cognitive impairment and the establishment of markers of moderate cognitive dysfunction. The papers were searched for in the Web of Science and PubMed databases. A list of cerebrospinal fluid, plasma, serum and genetic biomarkers was made, allowing for differential diagnosis between vascular impairment and Alzheimer's disease. The markers of moderate cognitive dysfunction, which make it possible to identify cognitive impairment at the pre-dementia stage, were also identified.

scholarly journals Therapeutic Potential of Remote Ischemic Conditioning in Vascular Cognitive Impairment

2021 ◽  
Vol 15 ◽  
Author(s):  
Rui Xu ◽  
Qianyan He ◽  
Yan Wang ◽  
Yi Yang ◽  
Zhen-Ni Guo
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Processing ◽  
Therapeutic Potential ◽  
Recurrent Stroke ◽  
Neurovascular Unit ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Remote Ischemic Conditioning ◽  
Ischemic Conditioning ◽  
Social Burden

Vascular cognitive impairment (VCI) is a heterogeneous disease caused by a variety of cerebrovascular diseases. Patients with VCI often present with slower cognitive processing speed and poor executive function, which affects their independence in daily life, thus increasing social burden. Remote ischemic conditioning (RIC) is a non-invasive and efficient intervention that triggers endogenous protective mechanisms to generate neuroprotection. Over the past decades, evidence from basic and clinical research has shown that RIC is promising for the treatment of VCI. To further our understanding of RIC and improve the management of VCI, we summarize the evidence on the therapeutic potential of RIC in relation to the risk factors and pathobiologies of VCI, including reducing the risk of recurrent stroke, decreasing high blood pressure, improving cerebral blood flow, restoring white matter integrity, protecting the neurovascular unit, attenuating oxidative stress, and inhibiting the inflammatory response.

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